Lymphoproliferative disorders after lung transplantation: imaging features.
OBJECTIVE
To define the imaging features of lymphoproliferative disorders that occur after lung transplantation.


METHODS
In a retrospective review of the cases of 246 patients who had undergone lung transplantation (62 single- and 184 double-lung transplants) between 1987 and 1997, the authors found nine patients (seven men and two women, aged 16-59 years [mean, 42.2 years]) with posttransplantation lymphoproliferative disorders. All imaging, clinical, and pathologic findings pertaining to these disorders were reviewed.


RESULTS
Eight of the nine patients had isolated intrathoracic disease. The most common abnormality (six patients) was the presence of multiple, well-defined pulmonary nodules. These nodules, when multiple, had basilar and peripheral predominance. Other abnormal features included hilar or mediastinal adenopathy (two patients), a consolidated upper lobe (one patient), a pleural mass (one patient), and bulky abdominal lymphadenopathy (one patient with pathologically proved Hodgkin lymphoma). Three patients had nodules with a surrounding area of ground-glass opacity (halo sign), and one patient had multiple ill-defined areas of centrilobular opacity. Air bronchograms were not often seen, and pleural effusions were absent.


CONCLUSIONS
The presence of well-defined pulmonary nodules in a patient who has undergone lung transplantation should raise concern about the possibility of posttransplantation lymphoproliferative disorder. In such cases, performance of pathologic studies should be expedited.
Rappaport
D C
DC
Department of Medical Imaging, Toronto Hospital, Ontario, Canada.
Chamberlain
D W
DW
Shepherd
F A
FA
Hutcheon
M A
MA
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D016040:Lung Transplantation; D008232:Lymphoproliferative Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed